HomeMy WebLinkAbout3412 RESOLUTION NO. 3 4 1 2
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF AUBURN,
VVASHINGTON, AUTHORIZING THE MAYOR AND CITY CLERK TO ENTER
INTO AN AGREEMENT BETWEEN THE CITY OF AUBURN AND KING
_ _ _ _
COUNTY SEXUAL ASSAULT RESOURCE CENTER DURING THE YEAR
2002.
THE CITY COUNGIL OF THE CITY OF AUBURN, WASHINGTON, IN A
REGULAR MEETING DULY ASSEMBLED, HEREWITH RESOLVES THAT:
Section 1. The Mayor and City Clerk of the City of Auburn are herewith
authorized to enter info an Agreement between the ,City of Auburn and King -
County Sexual Assault Resource Center, a local non-profit charitable
organization, to provide human services to Auburn residents as described in
said Agreement for the year 2002. A copy of said Agreement is attached
hereto and denominated Exhibit "A".
Section 2. The Mayor is hereby authorized to implement such
administrative procedures as may be necessary to carry out the directives of
this legislation.
DATED and SIGNED this 19th day of February, 2002.
CITI( OF AUBURN
� __�"
PETER B. LEWIS
MAYOR
Resolution No. 3412
January 28, 2002
Page 1
ATTEST:
�
,
Danielle E. Daskam,
City Clerk
APPROVED AS TO FORM:
niel B. Heid,
City Aitorney
Resolution No. 3412
Janua:.ry 28; 2002
Page 2
AGREEAAENT FOR SERVICE8
THIS AGREEMENT made and entered into this �� day of
__ , 2002, by and between the CITY OF AUBURN, a municipal.
corporation of the State of Washington, hereafter referred to as "CITY", and KING
COUNTY SEXUAL ASSAULT RESOURCE CENTER, which is located at P.O. Box 300
Renton, WA 98057, a non-proft corporation organized under the laws of the State of ,
Washington, hereafter referred to as "AGENCY." I
WHEREAS, The AGENCY provides a valuable service to the CITY and its
residents through the provision of eounseling, crisis line, support, including legal
advocacy, for victims of sexual assault; and
WHEREAS, the CITY is interested in continuing support ofComprehensive Sexual
Assault Services; including development of additional resources and service sites, for low
income Aubum residents;
NOW, THEREFORE; In consideration of the covenants and conditions of this
Agreement, the parties agree as follows:
I. PURPOSE.
� The purpose of this Agreement is to provide for an appropriation to the AGENCY
for providing services as set forth in Exhibit A, and incorporated herein by this reference
as if fully set forth, to Auburn residents during the 2002 term. This support is in recognition
of the fact that fhe demand for the services delivered by the AGENCY continues to rise.
II. SC_OPE OF SERVICES.
A. The parties agree and understand that the AGENCY agrees to provide services,
as described in Exhibit "1", which may include development of new resources, to low
Agreement—GF-0222,King County Sexual Assault Resource Center
January 15,2002 .Resolution 341 2 I
Page 1 of 9
Exhib i t "A" '
income Auburn residents. Services to be provided are set forth in Exhibit "1" to this
agreement, and. incorporated herein by this reference as if fully set forth.
B. The Agency agrees to provide at a minimu.m the services outlined on Exhibit 1,
Said services are to be completed no later than December 31, 2002.
III. TERM. ,
The term of this Agreement shall commence on January 1, 2002 and shall expire
on December 31, 2002.
IV. PERFORMANCE REPORTS AND COMPENSATION
A. The AGENCY shall pravide to the City within 15 days of the close of each calendar
quarter a status report containing program statistics regarding the type and level of .
services provided to the City of Aubwrn, as well as financial information pertaining to the
contract agreement and expenditures. The final report, which may include estimated
service levels, shall be submitted no later fhan December 15, 2002. Format and contents
of these reports are set forth in Exhibits 1 to 3 to this Agreement, which are incorporated
herein by this reference,
B, The Agency shaU prepare and submit to the City two program evaluation reports in
the format commonly referred to as the °Logic Model" which will show the intended
linkages befinreen the activities conducted and the changes the activit'tes will produce.
These reports shall contain information as set forth in Exhibit 4 to this Agreement, which is
incorporated herein by this reference, and shall be submitted to the City at the end of:the
first quarter and within sixty days following the close of the calendar year.
C. As full and total payment for the services provided under this Agreement, tFie CITY
agrees to pay the AGENCY the total amount of$27,795.00 as set forth in ExHibit 1. The
Agreement—GF-0222,King County Sexual Assault Resource Center
January 15,2002
Page 2 of 9
CITY will pay an amount equal to one-quarter of the total amount within thirty (30) days
following the CITY's receipt of quarterly invoices. The required format and content of
quarterly invoices is set forth in Exhibit 4 to this Agreement, and is incorporated herein by
this reference.
VI. INDEIIANIFICATION.
The AGENCY agrees to defend, indemnify, and hold harmless the CITY, its
elected and appointed officials, employees and agenfs from and against any and all
claims, demands and/or causes of action of any kind or character whatsoeyer arising out
of or relating to services provided by the AGENCY, its employees, volunteers or agents
conceming any and all claims by any persons for alleged injury or damage to persons or
property fo the extent caused by tfie negligent acts, errors or omissions of the AGENCY,
its employees, volunfeers or agents or representa#ives. In the event that any suit or claim
for damages based upon such claim, action, loss or damage is brought against the CITY,
the AGENCY shall defend the same as its sole costs and expense; provided that the CITY
retains the right to participate in said suit if any principle of governmental or public law is
involved; and if final judgment be rendered against the CITY and/or its officers, elected
offieials, agents and employees or any of them or jointly against the CITY and the
AGENCY and their respective officers, agents, volunteers, employees or any of them, the
AGENGY shall fully satisfy the same and shall reimba�se the CITY any costs and expense
which the CITY has incurred as a cesult of such claim or suit. The provisions of this section
shall survive the expiration or termination of this Agreement.
VII. IPIDEPEMDENT CONTR�4CTOR/ASSIGNAAENT.
The parties agree and understand that the AGENCY is an independen# contractor
and not the agent or employee of the CITY and that no Iiability shall attach to the CITY by
_
--------------------------------------
Agreement—GF-0222,Kmg County Sexual Assault Resource Center
January 15,2002
Page 3 of 9 '
reason of entering into this Agreement except as provided herein. The services required
wnder this Agreement may not be assigned or subcontracted by the AGENCY without the
prior written consent of the CITY.
VIII. INSURANCE.
The AGENCY shall procure and maintain for the durafion of this Agreement
insurance against claims for injuries to persons or property which may arise from or in �
conneetion with services provided by the AGENCY, it agents, employees or volunteers
� under this Agreement. The AGENCY agrees to provide comprehensive general liability
insurance and shall maintain liabilify limits of not less than ONE MILLION DOLLARS
($1,000,000) combined single limit coverage per occurrence for bodily injury, personal
injury and property damage. Where professional services are prouided as part of the
services rendered pursuant to this Agreement, as shown in Exhibit 1, the AGENCY shall
also provide and maintain professional liability coverage including errors and omissions
coverage in the minimum liability amount of ONE MILLION DOLLARS ($1,000,000)
combine.d single limit per occurrence for bodily injury, personal injury and property
damage. Any deductibles or self insured retentions in either policy must be declared to
and approved by the CITY. At the option of the CITY either: The insurer shall reduce or
eliminate such deductibles or self insured retentions as respeets the CITY, its offcials and
employees, or, The AGENCY shall procu�e a bond guaranteeing payment of losses and
related investigations, claim ad.ministration and defense expenses. The policies are to
contain or be endorsed to confain the following provisions:
1) GENERALLIABILITYCOVERAGE:
Agreement—GF-0222,King County Sexual Assault Resource Center
January 15,2002
Page 4 of 9
The CITY, its elected and appointed officials, employees and agents are to be
covered as additional insureds as respects: Liability arising out of services and
activities performed by or on behalf of AGENCY, its employees, agents and
volunteers. The coverage shall contain no special limitations on the scope of
protection afforded to the CITY, its elected and appointed officials, employees or
agents.
2) GENERAL LIABILITY AND PROFESSIONAL LIABILITY COVERAGES:
(a) The AGENCY's insurance coverage shall be primary insurance as respects the
CITY, its officials, employees and agents. Any insurance or self insurance
maintained by the CITY, its officials, employees or agents shall be in excess of
the AGENCY's insurance and shall not contribute with it.
_ _
(b) Any failure to comply with reporting provisions of the policy shall not affect
coverage provided to the CITY, its officials, employees or agents.
(c) Coverage shall state that the AGENCY's insurance shall apply separately to
each insured against whom claim is bought or suit is brought except with
respect to the limits to#he insurer's liability.
(d) Each insurance policy required by this clause shall be endorsed.to state that
coverage shall not be suspended, voided, canceled, reduced in coverage, or in
limits exeept after thirty (30) days prior written notice by certified mail refurn
receipt requested has been given to the CITY. The AGENCY agreesto proyide
copies of the Certificates of Insurance to the CITY at the time that this
Agreement takes effect.
(e) The AGENCY shall fumish the CITY with Certificates of Insurance and with
original endorsements a.ffecting coverage required by this clause. The
Agreement—GF-0222,King County Sexual Assault Resource Center
January 1 S,2002
Page 5 of 9
certificate and endorsements for each insurance policy are to be signed by a
person authorized by that insurer to bind coverage on its behalf. The CITY
reserves the right to require complete, certified copies of all required insurance
policies at any time.
(� The AGENCY sha11 include all volunteers, employees and agents under its
policies or shall furnish sepa"rate certificates and endorsements for each. All
coverages for volunteers shall be subject to all the requirements stated herein.
IX. NONDISCRIMINATION.
The AGENCY shall not discriminate under any services or programs to which this
Agreement may apply directly or through confractual or other arrangements on the
grounds of race; color; creed, religion, national origin, sex, age, or the presenee of any
sensory, mental or physical handicap.
X. BOOKS AND RECORDS.
The AGENCY agrees to maintain separate accounts and records in accordance
with Sta.te Auditor's procedures, including personnel, propertq, financial and programmatic
records which sufficiently reflect direct and indirect costs and services perFormed under
this Agreement, The AGENCY agrees to maintain all books and records relating to this
Agreement for a period of three (3) years following the date that this Agreement is expired
or othennrise terminated. The parties agree that the CITY OF AUBURN may ins"pect such
documents upon good cause at any reasonable time within the three (3) year period.
XI. TERMINATION OF AGREEMENT. .
Agreement—GF-0222,King County Sexual Assault Resource Center
January 15,2002
Page 6 of 9
This Agreement may be terminated by either party upon ten (10) days written
notice should the other party fail substantially to perform in accordance wifh its terms
through no fault of the other.
XII, GENERAL PROVISIONS.
A. The AGENCY agrees to submit a report to the CITY no later than
December 15, 2002, describing the progress and activities perFormed for
the year 2002 under its scope of services.
B: This Agreement shall be goVerned by the laws, regulations and ordinances
of the City of Aubum, the State of Washington, and County of King and
where applica6le, Federal laws.
G The CtTY and the AGENCY respectively bind themselves, their
successors, volunteers, assigns and Iegal representatives to the other party
to this Agreement and with respecf to all covenants to this Agreement.
D. This Agreement represents the entire and integrated Agreement between
the CITY and the AGENCY and supersedes all prior negotiations. This
- Agreement may be amended only by written instrument signed by both the
CITY and the AGENCY. •
E. Should it become necessary to enforce any term or obligation of this
Agreement, then all costs of enforeement including attorneys fees and
expenses and court costs shall be paid to the substantially prevailing party.
F. The AGENCY agrees to comply with all local, state and federal laws
applicable to its performance under this Agreement.
Agreement—GF=0222,King County Sexual Assault Resource Center
January 15,2002
Page 7 of 9
CITY OF AUBURN
�
� �
PETER LEWIS
MAYOR
A ST: ,
� �,
Danielle E. Daskam,
City Clerk
AP TO R :
b ' f He ,
ity Attomey
KING COUNTY SEXUAL ASSAULT RESOURCE CENTER
BY: %"�/�',������i�
� -
� TITLE: ��
STATE OF WASHINGTON )
)ss
COUNTY OF KING )
On this 3l'—� day of J , 2002, before me, the undersigned, a.
Notary Public in and for the State— vi Washington, personally � appeared
, to me known to be the Executive Director of King Gounty
Sexual Assault Resource Center, the non-profit corporation that executed the within and foregoing
instrument, and acknowledged said insfrument to be the free and voluntary act and deed of said
non-profit corporation for the uses and purposes therein mentioned, and on oath stated that he/she
is au#horized to execute said instrument on behalf of said non-profit corporation.
IN V1,�`TNESS WHEREOF, I have hereunto set my hand and affixed my official sealthe date
her 9�����`,1
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�'If�'�,� �,, p�g1,1� `� �� NOTAR PU_B-LIC in and f r the S te of
I��1�'q�''��:���g� � MY COMMISSION e pires: � �o
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Agreement—GF-0222,King County Sexual Assault Resource Center
January 15;2002
Page 8 of 9
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�
� ' - .• ffi�• /` �"• " �
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� � ,''��� • EXHIBIT 1,GF-0222
� ' '� � � CITY OF AUBURN
' r��� UMAN SERVIGE AGREEMENT
� 2002 SCOPE OF S VICES AND QUARTERLY SERVICE UNIT REPORT
`i,; !k l . . . . .
Agency In " � 'ti; n<a'
King County Sexu.al Assault Resource Center 425-226-5062 x229
P.O. Box 300 425-235-7422
Renton,WA 98057 flciuchi@kcsarc.org
Contaet: Frank Kiuchi Title: Director of Finance&Admin.
Are professional serviees (e.g., counseling, case management) provided as part of this
Agreement? yes
Confract Information
Contract Amount: $27,795.00 Program Name: Comprehensive Sexual Assault Services !
Description of Service to be provided: eounseling,crisis line,support,including legal advocacy,for
victims of sexual assault
Reporting Information
Report for _1 St Qtr/Jan-Mar _2nd�tr/Apr-Jun _3rd Qtr/Jul-Sep _4�'Qtr/Oct-Dec
2002 Service Units
City Funding All Funding Sources Actual Service
Onl Units to Date,
Total
Service Unit Description: Projected Actual Units by�uarter all Fund
Auburn Res/dents Only Annual Units Sources
Service UniUPerformance Measure 1St 2^a 3`� 4m
Unduplicated Number of Auburn 85
Clients Served
LegalAdvocaey House 263 ,
Narrative: Please attach other relevant information, including current frends, program developments,
special events, publicity,communify education, etc. If acfual service units are lower than anticipated,
please explain.
EXHIBIT 2,GF-0222
CIT1( OF AUBURN
2002 Quarterly Financial Report
Agency: King County Sexual Assault Resource Center Date: _ __
Program; Comprehensive Sexual Assault Services
Report for _1 st Qfr/Jan-Mar _2nd Qtr/Apr-Jun =3`d Qtr/Jul-Sep _4�'Qtr/Oct-Dec
Cost Categories Budget This Cumulative Award
Award Request to date Balance
1 Personal/Agency Services $27,795
2 Office/Operating Supplies
3 Consultant or Purchased
Services
4 Direct Client Assistance
5 Communications
6 Travel &Training
7 Intra-Agency Support
8 Other per Detail
Grand Total $27,795.00
Requested
Reimbursement:
Detail as Applicable:
EXHIBIT 3,GF-0222
CITY OF AUBURN
2002 Demographic Report
Agency: King County Sexual Assault Resource Center Date:
Program: Comprehensive Sexual Assault Services
Caf,._o- - -- _ _- ---_. 1 ,2 ___. 3. - _ - --- —4 - _ _Total'YTD
__ __ .
Client AI ona
Residence" Aubum
Black Diainond
"List•all clients Burien
'served in this - - __ _ _
_ _ - _ _
category.
Covin on
In all other Des Moines
categocles Ilsf Enumclaw
Aubum cllents Federal Wa
only. Kent
Ma le Valle
Normand Park
Pacific
Renton
SeaTac
Seattle
Tukwila
_ _ - - -_
Uninco orated.Kin Coun
Other:
Unknown
-----------
TOTAL
-------- ---- - -
Glien4 30'/0 of inedian or below
_.. . _.
Income 50%of inedian or below
`Level 80%a of inedian or below
` Above 80%of inedian
Unknown
TOTAL
Client Female
:Gend"er_._ _ Male
_ _ _
_- ----.._
Client 0-4 .
Age 5-12
13-17
18-34
35-54
55-74
75+
Unknown
__ ____
TOTAL
Etfinicity/ AsiaNPacific Islander
Cultural Black/African American
_ __ _ _ _
Background His anic/Latino
Native American/Alaskan Native
White/Caueasian
Other
Unknown
- _ - _ _ . _ _
-- --.
TOTAL
_. _
Condition . Disablin Condition
ESL" Limited En lish S eakin
Household_______. Female-Headed Household
EXHIBIT 4,GF-0222
CITY OF AUBURN
Logic Model Evaluation Format
Agency: King County Se�al Assault Resource Center Date: _ _
Program: Comprehensive Sexual Assault Services
I. Submission Dates.
This report shall be submitted with the first quarter invoice and again within sixty (60) days of
the end of the calendar year.
II. Contents.
A. The components of the evaluation will:
1) Identify both process and outcome portions of counseling, crisis line, support,
including legal advocacy, for victims of sexual assault;
2) Show the relationship of program resources and activities to the expected results or
outcomes;
3) Help identify those questions the evaluation is to answer;
4) Provide a graphic summary of how program parts relate to the whole;
5) Make explicit the underlying theory of the program; and �
6) Identify measurable categories in the program evaluation.
B. King Counry Sexual Assault Resource Center shall develop the following status report
components within the time frames established below:
1) 1 St Quarter 2002
a) The outcome based results King County Sexual Assault Resource Center
expects to achieve;
b) An indicator to inform the King County Sexual Assault Resource Center that the
anticipated change has or has not occurred; and
c) The method for gatfiering information needed to indicate the outcomes that have
occurred.
d) Initial Gollection and assessment of the information acquired to include:
alterations in the anticipated outcomes or alteration in the methodology of
information gathering.
2) 4"'Quarter 2002 '�
a) Information collected; '�
b) Conclusions developed as a result of the information.
COVER PAGE,GF-0222
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2002 IIVVOICE FOR COIVTRACTED SERVICES
To: City of Auburn, Attn: Shirley Aird, Planning Department
25 West Main, Auburn, WA 98001
Agency: King County Sexual Assault Resource Center Date:
P.O. Box 300 425-226-5062 x229
Renton,WA 98057 425-235-7422
fkiuchi@kcsarc.org
Contact; Frank Kiuchi
Invoice for: 1 g`Quarter, January to March-Due April 15, 2002
2"�Quarter, April to June-Due July 15,2002
3rd Qu.arter,July fo Sepfember-Due October 15, 2002
4"'Quarter(Preliminary, Cover sheet and Ex. B only) October to December-Due
December 13,2002
4"'�uarter(Final) October to December-Due January 31, 2003
Amount Requested:
Required Attachment Checklist: Exhibit A-�uarterly Service Report
Exhibit B-Quarterly Financial Report
Exhibit C-Demographic Report(2"d and 4th Quarters only)
Logic Model/Outcomes Report(1S'and 4�'Quarters only)
_Froof of Insurance(1S�quarter and/or if expired since last
reimbursement request)
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents.
___ - - _ - _ _ _- - -__ _ ___- - -- — --__--- -- - - -
Signature of Authorized Representative Date
The Gity of Aubum will issue payment upon this invoice within thirty(30) business days of receipt.To
ensure prompt payment, please submit this form and all required attachments by the date listed above.
FOR CITY OFAUBURN USE ONLY:
Contraet Amounf: $27,795.00
Payments Year to Date: Date:
Date:
Date:
Date:
Payment this invoice: Contract Balance:
Authorized to Pay:
Signature Date
COVER PAGE-MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
�1CORD�, C�RTI�IC�11T� O� �IA�I�ITY INSURANCE ii"i�'002
PROOUCER THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION
WILLIAM F. DAVIS INSURANCE AGENCY INC. ONLY AND CONFERS_ NO RIGHTS UPON THE CER7IFICATE
� HOLDER. THIS CERTIFlCATE DOES NOT AMEND, EXTENO OR
P.0. BOX 452 ALTER THE COVER�►GE AFFORDED BY THE POLICIES BELOW.
RENTON, WA. 98057 INSURERS AFFORDING COVERAGE
425 255.-68.72_ . _
_ _ _—.
iNsuReo J - - iNsuRERn: WESTERN WORLD INSURANCE COMPANY
— - --
KING COUNTY SEXUAL ASSAULT RESOURCE CENTER trvsuReas: UNIGARD INSURANCE COMPANY
P.O. BOX 300 INSUFERC:
_ _ _ _
RENTON, ti,lA. 9BOS7 INSURERD:
� INSURER.E:
-
COVERAGES
THE POUCIES OFINSURANCE USTED BELOW HAVE.BEEN ISSUED TO THE.INSURED NAMED ABOVE FOR THE POUCY PERI00 INQICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR
MAY PERTAIN,THE INSURANCE AFFORD,ED BY THE PO�iCIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS.
INSR � POUCY EfFECTIVE POIICY EXPIRATION -
TYPEOF INSURANCH �� POLICY NUMBER., _ _ UMITS
�GENERAL UABILITY ' EACH OCCURRENCE $1�OOO�OOO
a ��COMMERCIAL CaENERAL UABILITY FIRE DAMAGE(My one tire) E SO OOO
�- NPP720373/1 11-23-2002 11-23-2003 -- 1,000
� CLAIMS MADE �OCCUR �MED EXP(Any orre person) t.
�X-. �SIQP GAP — PERSOr,nL 8 ADV IwURY S 1,000,OOO
GENERAL AGGRECiATE S 2�OOO�OO
GEN'L AGGREGATE LIMIT APFLIES PER: PRODUCTS-COMP/OP AGG s I NCL ED
POUCY �a LOC
___
AUTOMOBILE LIABILITY
COMBINED SINCiLE'LIMIT
ANY AUTO I � (Ea acctdenq S 1�000�000
� , ALL OWNED AUTOS
8001LY INJURY a
SCHEOUCED AUTOS (Pe�Pe�^)
6 N�REDAUTOS PX808932 11-23-2002 11-23-2003 BOOILYINJURY
NON-OWNEO AWTOS �p�e��) S
-- : PROPERTY DAMAGE $
� i (Per aatident)
OARAf3E LIABIIITY ,
i 4 AUTO ONLY-EA ACCIDENT E
�_I ANY AUTO I ' �A� f
OTNEH THAN -
� AUTO ONIY: AGQ S
�EXCESS I.IABIUTY �EACH OCCURRENCE E
OCCUR �ClA1MS MADE �AGCREGATE E
� 1 �
DEDUCTIBIE . r�
t S
RETENTION S _ _ S
WORKERS COMPENSATION AND WRY TAM� �p'
EMPLOYERS'LIABILITY -
E.L.EACH AGCIDENT S
E.4 DISEASE-EA EMPLOVE S �
E.L.61SEASE-POUCY LIMIT S ^
OTHER
A PROFESSIONAL LIABIL TY NPP720373/1 11-23-2002 11-23-2003 $1,000,000 EA. INCIDENT
`
DESCRIPTION OF OPERAT�ONSILOCATIONSNEHICIES/EXCLU510NS ADDED BY ENDORSEINENT/SPECIALPROVISICNS
CERTIFICATE tiOLDER IS AN ADDITIONAL INSURED AS RESPECTS: CONTRACT ISSUED FOR OPERATIONS
AS SEXUAL ASSAUIT AND EDUCATION SERVICE.
-- - ---- -._-- ------------_ �S �( Z-
- --- ----- ----. _.--------
__ __
CERTIFICATE HOLDER ' X ADDITIONAL INSUREO;orsuaep�erreA: _ _CANCELLATION
C I T Y 0 F A U B U R N SHOULD ANY OF THEABOVE DESCRIBED POIICIES BE CANCELLED BEFORE THE EXPIpAT10N
DATE THEREOF,THE ISSUIN(i INSURER WILL ENDEAYOR TO MAIL � DAYS MIRITTEN
AUB�JRN C I TY C LERK NOTICE TO THE CERTIFICATE HOIDER NAMED TO THE LEFT;8U7 FAIWRE TO DO SO SHALL
ZS WEST MAIN IMPOSE.NO OBUOATION OR LWBILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
AUBURN� WA. 98001 R�r�s�rArn�s.
A'UTHORIZED ii ESENTA7IVE �
�`'�`
ACORD 25-S(7/97) O ACORD RPORATION 1988